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Table 1 Characteristics of confirmed leptospirosis cases according to initial clinical diagnoses at sites

From: Leptospirosis in Indonesia: diagnostic challenges associated with atypical clinical manifestations and limited laboratory capacity

 

Clinical Diagnosis at Site

Dengue

(n = 11)

Typhoid fever

(n = 4)

UTI

(n = 5)

CAP

(n = 3)

Othera

(n = 6)

Leptospirosis

(n = 22)

Total

(n = 51)

Demography

 Gender (male: female)

10:1

1:3

2:3

2:1

3:3

16:6

34:17

 Adult: Pediatricb

9:2

4:0

4:1

3:0

4:2

22:0

46:5

 Age, median (range)

29 (5.3–58.1)

42.3 (19.2–60.4)

27 (10–61.4)

62.5 (59.7–64.4)

47 (13–85)

41.7 (20.8–62.1)

41.2 (5.3–85)

Signs & Symptoms, N (%)

 Anorexia

3 (27.3)

2 (50)

0

1 (33.3)

3 (50)

7 (31.8)

16 (31.4)

 Chills

4 (36.4)

2 (50)

3 (60)

2 (66.7)

1 (16.7)

9 (40.9)

21 (41.2)

 Lethargy

2 (18.2)

1 (25)

1 (20)

0

1 (16.7)

10 (45.5)

15 (29.4)

 Icterus

2 (18.2)

0

0

0

1 (16.7)

6 (27.3)

9 (17.6)

 Decrease of consciousness

0

0

0

0

1 (16.7)

0

1 (1.9)

 Headache

5 (45.5)

3 (75)

3 (60)

1 (33.3)

3 (50)

13 (59.1)

28 (54.9)

 Dizziness

2 (18.2)

1 (25)

3 (60)

2 (66.7)

2 (33.3)

6 (27.3)

16 (31.4)

 Cough

2 (18.2)

0

1 (20)

1 (33.3)

2 (33.3)

9 (40.9)

15 (29.4)

 Shortness of breath

0

0

0

0

0

4 (18.2)

4 (7.8)

 Epigastric pain

0

2 (50)

2 (40)

1 (33.3)

1 (16.7)

8 (36.4)

14 (27.5)

 Abdominal pain

2 (18.2)

0

0

0

1 (16.7)

5 (22.7)

8 (15.7)

 Nausea

8 (72.7)

4 (100)

4 (80)

3

4 (66.7)

17 (77.3)

40 (78.4)

 Vomiting

7 (63.6)

3 (75)

3 (60)

2 (66.7)

5 (83.3)

12 (54.5)

32 (62.7)

 Constipation

2 (18.2)

2 (50)

0

0

1 (16.7)

0

5 (9.8)

 Diarrhea

5 (45.5)

0

2 (40)

2 (66.7)

3 (50)

9 (40.9)

21 (41.2)

 Arthralgia

2 (18.2)

0

4 (80)

2 (66.7)

0

12 (54.5)

20 (39.2)

 Myalgia

1 (9.1)

1 (25)

3 (60)

1 (33.3)

1 (16.7)

15 (68.2)

22 (43.1)

 Skin rash

0

0

0

1 (33.3)

0

1 (4.5)

2 (3.9)

 Conjunctival suffusion

2 (18.2)

0

0

0

1 (16.7)

11 (50)

14 (27.5)

 Rhonchi

0

0

0

2 (66.7)

0

4 (18.2)

6 (11.8)

 Pruritus

0

1 (25)

0

0

0

0

1 (1.9)

 Gastrocnemius pain

1 (9.1)

0

0

0

1 (16.7)

6 (27.3)

8 (15.7)

 Oliguria

1 (9.1)

0

0

0

0

3 (13.6)

4 (7.8)

 Brown-coloured urine

0

0

0

0

0

7 (31.8)

7 (13.7)

Haematology & Chemistry Results, N (%) / N/tested (%)

 Leukopenia

0

0

1 (20)

0

1 (16.7)

0

2 (3.9)

 Normal leucocyte count

10 (90.9)

3 (75)

2 (40)

2 (66.7)

0

6 (27.3)

23 (45.1)

 Leukocytosis

1 (9.1)

1 (25)

2 (40)

1 (33.3)

5 (83.3)

16 (72.7)

26 (50.9)

 Platelet ≤150,000/mm3

8 (72.7)

2 (50)

1 (20)

2 (66.7)

1 (16.7)

16 (72.7)

30 (58.8)

 Granulocytosis > 80%

8/10 (80)

2/3 (66.7)

1/4 (25)

2/2 (100)

3/5 (60)

10/12 (83.3)

26/36 (72.2)

 Lymphopenia < 20%

9/10 (90)

4/4 (100)

2/4 (50)

2/2 (100)

5/5 (100)

13/13 (100)

35/38 (92.1)

 Total bilirubin > 1 mg/dL

3/11 (27.3)

1/3 (33.3)

0/4

1/3 (33.3)

0/5

15/22 (68.2)

20/48 (41.7)

 Bilirubin direct > 0.65 mg/dL

2/11 (18.2)

1/3 (33.3)

0/4

0/3

0/5

16/22 (72.7)

19/48 (39.6)

 ASTc > 100

1/11 (9.1)

0/3

0/4

0/3

0/6

7/20 (35)

8/47 (17)

 ALTd > 100

0/11

0/3

0/4

0/3

0/6

3/22 (13.6)

3/47 (6.4)

 Creatinine > 1.4 mg/dL

3/11 (27.3)

0/3

2/4 (50)

2/3 (66.7)

0/5

15/22 (68.2)

22/48 (45.8)

Diagnostic tests at sites, N/ tested (%)

 Dengue IgM positive

2/6 (33.3)

2/4 (50)

0/1

0/1

0/1

0/5

4/18 (22.2)

 Tubex TF®e

2/5 (40)

4/4 (100)

1/2 (50)

0/1

1/3 (33.3)

2/5 (40)

10/20 (50)

 Leptospira IgM positive

0/1

0/4

0/1

0/1

0/1

18/22 (81.8)

18/25 (72)

Reference Laboratory tests, N (%)

 Dengue & S. typhi

1 (9.1)

0

0

0

0

0

1 (1.9)

 Leptospira PCR & Serology

6 (54.5)

2 (50)

2 (40)

3 (100)

3 (50)

12 (54.5)

28 (54.9)

 Leptospira PCR only

2 (18.2)

0

0

0

1 (16.7)

2 (9.1)

5 (9.8)

 Leptospira serology only

3 (27.3)

2 (50)

3 (60)

0

2 (33.3)

8 (36.4)

18 (35.3)

Outcome, N (%)

 Death

1 (9.1)

1 (25)

0

0

0

0

2 (4)

  1. adiarrhea (2), sepsis (1), pharyngitis (1), ulcus pedis (1), undifferentiated fever (1)
  2. badult aged ≥18 year old; pediatric aged ≥1 - < 18 year old
  3. Signs and symptoms in italics were not obtained from all patients as they were not included in the case report form. They were extracted from chart review
  4. cAST: aspartate aminotransferase
  5. dALT: alanine aminotransferase
  6. eTUBEX TF® is a rapid diagnostic test to detect IgM antibodies against Salmonella typhi. Scores of 4–6 were considered positive
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BMC Infectious Diseases

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